<div class="modal fade lead-modal in" id="lead-modal" role="dialog" aria-labelledby="myLargeModalLabel">
    <div class="modal-dialog modal-dialog-centered">
        <div class="modal-content data">
            <div class="modal-header text-center modal_headerBg_color">
                <h5 class="modal-title text-white">{{@$data['title']}} </h5>
                <button type="button" class="close text-white" data-dismiss="modal" aria-label="Close">
                    <svg xmlns="http://www.w3.org/2000/svg" class="icon" width="24" height="24" viewBox="0 0 24 24"
                        stroke-width="2" stroke="currentColor" fill="none" stroke-linecap="round"
                        stroke-linejoin="round">
                        <path stroke="none" d="M0 0h24v24H0z" />
                        <line x1="18" y1="6" x2="6" y2="18" />
                        <line x1="6" y1="6" x2="18" y2="18" />
                    </svg>
                </button>
            </div>
            <div class="modal-body">
                <div class="row p-5">
                    <div class="col-md-12">                        
                        <form action="{{ $data['url'] }}" method="POST">
                            @csrf
                            <div class="form-group">
                                {{Form::label('payment_note','Note', ['class' => 'form-label required']) }}
                                <input type="text" placeholder="{{ _trans('payment.Enter payment note') }}" name="payment_note" class="form-control" required >
                            </div>
                            <div class="form-group text-right">
                                <button type="submit" class="btn btn-primary pull-right"><b>{{
                                         _trans('common.Submit') }}</b></button>
                            </div>
                        </form>

                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
